Fabiola Santiago: Hit to Florida hospitals is no surprise

The re-election of Gov. Rick Scott and a cadre of legislators who opted against Medicaid expansion is barely a week old, and here we go again: Another round of hand-wringing over the loss of federal healthcare dollars has begun.

But why lament after the fact? Was everyone asleep during the discussion of the issue when it mattered during the campaign?

Scott’s Florida opted out of the Affordable Care Act’s Medicaid expansion — for which it would get more than $51 billion in federal funds over 10 years. And come June, the federal dollars states were getting from the Low Income Pool (LIP) to care for the uninsured is going away, as stipulated in the ACA.

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Without the expansion of Medicaid in Florida — home to the second-largest rate of uninsured in the country — and without the LIP dollars, hospitals that treat those patients stand to lose billions.

At Jackson Health System, which serves the bulk of Miami-Dade’s uninsured, the financial impact of the double whammy is estimated at $570 million a year. At other Miami-Dade hospitals it’s a combined $60 million a year, and in Broward, Palm Beach and Monroe hospitals, the loss would be more than $500 million.

These figures appear in a report released Monday by Florida Legal Services, a nonprofit legal advocate for the poor. They’re the same numbers bandied about during the last legislative session’s failed attempt to accept federal dollars to expand Medicaid.

The Republican-dominated Legislature didn’t go for it — not even with an important election looming. But instead of sending a resounding message by punishing Scott and the Republicans, it was partisan business as usual. Support was given along party lines, not based on voting record or issues.

State Sen. Rene Garcia, who broke with his colleagues to sponsor the bill to push for Medicaid expansion last session, campaigned for Scott in his hometown of Hialeah. Republican colleagues squashed his bill — and still Garcia dutifully campaigned for the Republicans in a community where the need for federal dollars is great. The sweet elderly applauded and hugged Scott and said silly things on TV, including that Scott was loved “like a son” in this town.

Newbie Democrat Charlie Crist pledged he would push for Medicaid expansion in Florida if elected. But not enough people heard him, or cared.

Scott made no such promise, although he made wishy-washy remarks that made him appear more willing to accept Medicaid expansion dollars.

With Republican commitment to party and the apathy of Democrats and independents, who outnumber Republicans in Miami-Dade but didn’t vote, Scott and the Republicans won the elections.

Those who elected, or helped with their endorsements, to send the same tight-wads (at least when it comes to the poor) back to Tallahassee are now worried. But the losses of dollars to care for the uninsured was a predictable consequence of low voter turn-out and a Republican win.

An opportunity to reconsider Medicaid expansion opens when the Legislature reconvenes, but why expect a different, smarter result?